title: Carriers of filaggrin gene (FLG) mutations avoid professional exposure to irritants in adulthood.
abstract: BACKGROUND
  Loss-of-function mutations in the filaggrin gene (FLG) are associated with xerosis, atopic dermatitis, and early onset of hand eczema. Irritant exposure is a risk factor for occupational hand eczema, and FLG mutations increase the risk of occupational irritant contact dermatitis on the hands in hospital cohorts. It is unknown whether FLG mutations affect the level of irritant exposure.
  
  
  OBJECTIVE
  To evaluate whether exposure to occupational irritants was dependent on FLG mutations, atopic dermatitis, and age at hand eczema onset.
  
  
  METHODS
  Randomly chosen Danish adults completed a questionnaire on general health and occupational exposures. Genotyping for FLG mutations (R501X, 2282del4, and R2447X) and patch testing were performed.
  
  
  RESULTS
  Overall, 38.7% of subjects reported present or previous occupational exposure to irritants. Among individuals who reported hand eczema onset before entering their work life, 50.6% (45/89) of FLG non-mutation carriers became exposed to irritants, as compared with 28.6% (4/14) of heterozygous and 0% (0/6) of homozygous mutation carriers (p = 0.006). Avoidance was conspicuous among mutation carriers reporting childhood hand eczema and atopic dermatitis (odds ratio 0.08, 95% confidence interval 0.01-0.65).
  
  
  CONCLUSIONS
  Carriers of FLG mutations who have had hand eczema onset in childhood avoid occupational exposure to irritants; the association is most marked with homozygous mutation status combined with atopic dermatitis.
authors.affiliation: Department of Dermato-Allergology, National Allergy Research Centre, Copenhagen University Hospital Gentofte, Hellerup, 2900, Denmark.
authors.forename: Josefine
authors.initials: J
authors.lastname: Bandier
authors.forename: Katrine
authors.initials: K
authors.lastname: Ross-Hansen
authors.forename: Berit C
authors.initials: BC
authors.lastname: Carlsen
authors.forename: Torkil
authors.initials: T
authors.lastname: Menné
authors.forename: Allan
authors.initials: A
authors.lastname: Linneberg
authors.forename: Steen
authors.initials: S
authors.lastname: Stender
authors.forename: Pal B
authors.initials: PB
authors.lastname: Szecsi
authors.forename: Michael
authors.initials: M
authors.lastname: Meldgaard
authors.forename: Jacob P
authors.initials: JP
authors.lastname: Thyssen
authors.forename: Jeanne D
authors.initials: JD
authors.lastname: Johansen
mesh_terms: D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D000368:Aged; D001362:Avoidance Learning; D003430:Cross-Sectional Studies; D003718:Denmark; D003876:Dermatitis, Atopic / Q000175:diagnosis / Q000235:genetics* / Q000523:psychology; D017453:Dermatitis, Irritant / Q000175:diagnosis / Q000235:genetics* / Q000523:psychology; D009783:Dermatitis, Occupational / Q000175:diagnosis / Q000235:genetics* / Q000523:psychology; D005260:Female; D000091344:Filaggrin Proteins; D005819:Genetic Markers; D020022:Genetic Predisposition to Disease; D060005:Genotyping Techniques; D006306:Health Surveys; D006579:Heterozygote; D006720:Homozygote; D006801:Humans; D007381:Intermediate Filament Proteins / Q000235:genetics*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009154:Mutation; D016273:Occupational Exposure / Q000706:statistics & numerical data*; D010328:Patch Tests; D011795:Surveys and Questionnaires; D055815:Young Adult
chemical_list: C000717249:FLG protein, human; D000091344:Filaggrin Proteins; D005819:Genetic Markers; D007381:Intermediate Filament Proteins
keywords: filaggrin mutations; hand eczema; occupational irritant exposure